Mumbai hospitals start protocol review for transplants

From hiring third-party agencies for scrutinizing documents, to employing retired police or army officials for conducting donor-recipient interviews or running background checks, the hospitals are toying with several ideas to avoid the sticky situation that Powai’s Hiranandani Hospital is currently in.TNN | August 16, 2016, 08:15 IST

Mumbai hospitals start protocol review for transplantsMUMBAI: Almost all transplant centres in the city have begun a stringent review of their protocols that guide live-related surgeries, where organs are transplanted from a living donor related to the recipient. Most have already held sensitization sessions with their transplant teams, including doctors and coordinators, reiterating rules and violations.

From hiring third-party agencies for scrutinizing documents, to employing retired police or army officials for conducting donor-recipient interviews or running background checks, the hospitals are toying with several ideas to avoid the sticky situation that Powai’s Hiranandani Hospital is currently in. Two of its top officials, including CEO Dr Sujit Chatterjee and medical superintendent Dr Anurag Naik, have been arrested for failing to check document forgery in a kidney transplant case (the operation was stopped in the nick of time on July 14 by the police, who were called by activists).

The COO of Kokilaben Hospital, Andheri, Dr Ram Narain, said most hospitals are looking at tightening things even though the process is well-engineered. “One way to do it is to verify documents at the primary source. For instance, a marriage certificate will probably have to be cross-checked from the marriage bureau, or a birth certificate from the BMC, or a surprise physical visit to the residence of the donor if he/she claims to be related to the recipient,” he said. In his opinion, hospitals have to join hands to keep foul play out of the programme.

The Mumbai Metropolitan Region (MMR) has more than a dozen hospitals that carry out close to 200 liver and 400 kidney transplant surgeries annually. Transplants, over the years, have become a significant source of revenue for private hospitals. The fact that such hospitals are also seen as centres of excellence has only made it more lucrative. Hence, despite threats from doctors to not perform transplants, hospitals would want to keep running their programmes by finding ways to curb malpractice.

“From 15% to 20% of a hospital’s revenue could come from transplants. It is in our benefit to look for ways to outsmart touts. We are thinking of hiring an external agency that will run the first round of checks before it reaches the hospital’s transplant authorization panel. They may even carry out surprise visits. It will no doubt be an additional expenditure for the hospital, which could also push up transplant costs. But it’s better than going to jail,” said a top management official of a city hospital.

Nephrologist Dr Vishwanath Billa, who has quit Sion Hospital’s transplant programme over fears of working in a busy public hospital without any legal safeguards, suggested that the police or a government authority should take over the job of authenticating papers. “Let doctors and hospitals only be responsible for clinical care,” he said. Dr Chatterjee, before being taken into police custody, had told TOI that biometric or retina scan could be a great way to tackle racketeers.

Jaslok’s CEO Dr Tarang Gianchandani said the scam has made the hospital review its framework for risk management, legal compliance and double-check if rules are followed.